Publications by authors named "Daphne D'Amato"
Extra-intestinal manifestations in inflammatory bowel disease: a comparative review of pediatric and adult-onset disease.
Expert Rev Gastroenterol Hepatol
August 2025
Introduction: Inflammatory Bowel Diseases (IBD) are chronic immune-mediated disorders diagnosed in both adult and pediatric populations. In recent years, there has been a significant global increase in pediatric-onset IBD, not only in Western countries but also in newly industrialized regions. Age of onset plays a crucial role in disease behavior and prognosis, with pediatric onset often associated with a more extensive and aggressive disease.
View Article and Find Full Text PDFBackground & Aims: Several studies have assessed the short-term effectiveness and safety of obeticholic acid (OCA) in the real-world setting. We aimed to extend knowledge on the real-world effectiveness and safety of OCA treatment by expanding sample size and follow-up, and by exploring changes in liver stiffness measurement (LSM) over time.
Methods: The RECAPITULATE project involves centres belonging to the "Italian PBC registry" and/or the "Club Epatologi Ospedalieri" PBC working group.
Development and Validation of a Scoring System to Predict Response to Obeticholic Acid in Primary Biliary Cholangitis.
Clin Gastroenterol Hepatol
October 2024
Article Synopsis
- The study focused on creating a scoring system called the OCA response score (ORS) to predict how individuals with primary biliary cholangitis (PBC) will respond to the treatment using obeticholic acid (OCA).
- Data were collected from two large cohorts in Italy to derive and validate the score, which includes various clinical factors both before and after six months of treatment.
- The scoring system demonstrated good predictive ability for treatment response, which could help healthcare providers customize therapies for patients with PBC more effectively.
Article Synopsis
- Autoimmune liver diseases (AILDs) are complex and poorly understood conditions that include primary biliary cholangitis (PBC), autoimmune hepatitis (AIH), and primary sclerosing cholangitis (PSC), each with distinct treatment options and patient characteristics.
- While PBC and AIH have disease-modifying drugs to improve patient outcomes, PSC currently requires liver transplantation as the only effective treatment.
- Managing AILDs is challenging due to their rarity and the variability in how they present, highlighting the necessity for prognostic models that aid clinicians in assessing risks and providing personalized care based on markers of disease stage, activity, and treatment response.
Article Synopsis
- Hepatocellular carcinoma (HCC) is a significant health issue for cirrhotic patients with non-alcoholic fatty liver disease (NAFLD), and the study assessed non-invasive tests to predict HCC risk.
- Among 122 cirrhotic patients followed for about 6 years, 10.7% developed HCC, with the FIB-4 test showing a strong association with HCC risk.
- FIB-4 cut-offs of <1.3 and >3.25 effectively stratified long-term HCC risk, highlighting their potential use in clinical practice.
Article Synopsis
- Non-invasive tests (NITs) are being evaluated as alternatives to histology for assessing liver fibrosis in Non-Alcoholic Fatty Liver Disease (NAFLD), with the collagen-derived marker PRO-C3 showing promise.
- In a study with 96 NAFLD patients, liver stiffness (LS) demonstrated the highest accuracy for identifying advanced fibrosis, while the ADAPT score also showed strong performance.
- Over 12 months, LS decreased slightly, but both PRO-C3 and the ADAPT score significantly increased, suggesting these tools could effectively monitor liver disease progression and treatment responses.
Article Synopsis
- Chronic hepatitis (CH) patients with dysmetabolic or viral causes have poorer outcomes after contracting SARS-CoV-2, with about 31% of those studied experiencing COVID-19.
- Measurements of ACE2 and TMPRSS2 in these patients revealed that those with non-alcoholic fatty liver disease (NAFLD) had higher ACE2 levels than viral CH patients.
- Additional research is needed to fully understand how COVID-19 impacts individuals already suffering from liver diseases.
Article Synopsis
- MRCP is the best imaging method for diagnosing primary sclerosing cholangitis (PSC), but existing scoring systems have poor agreement among readers.
- A study evaluated quantitative MRCP metrics using AI-driven software to assess biliary features in PSC patients, finding that specific metrics like biliary strictures and spleen size predict the risk of complications.
- The new quantitative PSC score (qMRCP-PSC) showed better prognostic performance than current methods and could serve as a valuable tool for monitoring patients and evaluating treatment outcomes in clinical trials.
Article Synopsis
- Primary biliary cholangitis (PBC) is a chronic liver disease that results in inflammation and damage to bile ducts, leading to liver damage and fibrosis.
- The study examined liver biopsies from 87 patients with PBC to analyze the significance of ductular reactions in the disease’s progression and response to treatment with ursodeoxycholic acid (UDCA).
- Findings showed that extensive ductular reactions were associated with advanced disease, lower therapy effectiveness, and worse prognosis, indicating their importance as a marker for disease severity in PBC.
Article Synopsis
- The study investigates the safety and effectiveness of obeticholic acid (OCA) in patients with primary biliary cholangitis (PBC) who have advanced cirrhosis.
- Factors such as male sex, INR levels, Child-Pugh score, MELD score, and bilirubin levels were linked to non-response and serious adverse events (SAEs) in patients taking OCA.
- The findings suggest that careful baseline evaluations, especially bilirubin levels above 1.4 mg/dl, are essential in determining which patients can safely benefit from OCA treatment.
Article Synopsis
- Insulin resistance is key in the development of non-alcoholic fatty liver disease (NAFLD) and its progression to more severe conditions like non-alcoholic steatohepatitis (NASH).
- Irisin, a myokine released during exercise, shows potential links to energy regulation and NAFLD progression.
- The study found that higher levels of circulating irisin were associated with greater fibrosis, indicating that increased irisin may signal a more severe form of liver disease.
Article Synopsis
- Liver fibrosis is an important prognostic factor in primary biliary cholangitis (PBC), and this study aimed to evaluate the effectiveness of vibration-controlled transient elastography (VCTE) in diagnosing advanced fibrosis (AF) at disease presentation.
- A total of 167 PBC patients were analyzed, with VCTE demonstrating good diagnostic accuracy (AUROC of 0.89) for identifying AF, using specific liver stiffness measurement (LSM) cutoffs (≤6.5 kPa to rule out and >11.0 kPa to confirm AF).
- The findings indicate that while VCTE can accurately distinguish between the presence and absence of AF using certain LSM cutoff values, liver biopsy remains necessary for patients with intermediate L
Article Synopsis
- Obeticholic acid (OCA) is an effective second-line treatment for primary biliary cholangitis (PBC) patients who do not respond well to ursodeoxycholic acid.
- A study involving 191 patients showed significant reductions in liver enzyme levels after 12 months of OCA treatment, though patients with cirrhosis had lower response rates and a higher discontinuation rate due to adverse effects.
- Overall, the real-world effectiveness and safety of OCA align with earlier clinical trials, indicating potential benefits for certain patient subgroups, including those with overlap PBC-AIH.
Quality of life in patients with primary biliary cholangitis: A cross-geographical comparison.
Lorenzo Montali
,
Andrea Gragnano
,
Massimo Miglioretti
,
Alessandra Frigerio
,
Luca Vecchio
,
Daphne D'Amato
J Transl Autoimmun
January 2021
Article Synopsis
- The study aimed to explore how geographical location affects the quality of life and symptoms in patients with primary biliary cholangitis (PBC).
- Patients from the UK, Spain, Japan, and Italy were analyzed using the PBC-27 scale, revealing significant differences in symptoms like fatigue, cognitive issues, and emotional dysfunction based on country.
- Findings suggest that factors such as sun exposure, genetics, and culture may influence the symptoms and overall experience of PBC in different populations.
Article Synopsis
- PBC and PSC are autoimmune liver diseases with limited treatment options, but new research is uncovering potential targeted therapies.
- Understanding the roles of FXR and PPAR in PBC has led to clinical trials for new drugs aimed at improving liver function and reducing inflammation.
- PSC theories suggest gut health plays a crucial role, prompting approaches like lymphocyte trafficking blockers and fecal microbiota transplantation as emerging treatment strategies.
Letter: histology is relevant for risk stratification in primary biliary cholangitis.
Aliment Pharmacol Ther
January 2020
Article Synopsis
- Primary biliary cholangitis and primary sclerosing cholangitis are uncommon liver diseases that primarily impact the bile ducts, and there is still much to learn about their causes.
- Due to limited understanding, treatment options have historically been scarce, but new therapies are emerging that could improve patient care.
- This review focuses on summarizing research into new potential treatments for these conditions and explores how these advancements might transform existing approaches to treatment.